The characteristics of patients with possible familial hypercholesterolemia-screening a large payer/provider healthcare delivery system.


Journal

QJM : monthly journal of the Association of Physicians
ISSN: 1460-2393
Titre abrégé: QJM
Pays: England
ID NLM: 9438285

Informations de publication

Date de publication:
01 Jun 2020
Historique:
received: 12 10 2019
revised: 24 11 2019
pubmed: 29 12 2019
medline: 16 3 2021
entrez: 29 12 2019
Statut: ppublish

Résumé

Familial hypercholesterolemia (FH) is an under-diagnosed condition. We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH. A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population. The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated. By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

Sections du résumé

BACKGROUND BACKGROUND
Familial hypercholesterolemia (FH) is an under-diagnosed condition.
AIM OBJECTIVE
We applied standard laboratory criteria across a large longitudinal electronic medical record database to describe cross-sectional population with possible FH.
METHODS METHODS
A cross-sectional study of Clalit Health Services members. Subjects who met the General Population MED-PED laboratory criteria, excluding: age <10 years, documentation of thyroid, liver, biliary or autoimmune diseases, a history of chronic kidney disease stage 3 or greater, the presence of urine protein >300 mg/l, HDL-C>80 mg/dl, active malignancy or pregnancy at the time of testing were considered possible FH. Demographic and clinical characteristics are described at time of diagnosis and at a single index date following diagnosis to estimate the burden on the healthcare system. The patient population is also compared to the general population.
RESULTS RESULTS
The study cohort included 12 494 subjects with out of over 4.5 million members of Clalit Health Services. The estimated prevalence of FH in Israel was found to be 1:285. These patients are notably positive for, and have a family history of, cardiovascular disease and risk factors. For most of them the LDL-C levels are not controlled, and only a quarter of them are medically treated.
CONCLUSIONS CONCLUSIONS
By using the modified MED-PED criteria in a large electronic database, patients with possible FH can be identified enabling early intervention and treatment.

Identifiants

pubmed: 31883017
pii: 5688752
doi: 10.1093/qjmed/hcz327
doi:

Substances chimiques

Cholesterol, LDL 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

411-417

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

A Elis (A)

Department of Internal Medicine, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel.

M Leventer-Roberts (M)

Clalit Research Institute.

A Bachrach (A)

Clalit Research Institute.

N Lieberman (N)

Medical Policy Division, Clalit Health Services, Tel Aviv, Israel.

R Durst (R)

The Center for Research Prevention and Treatment of Atherosclerosis, Hadassah Hebrew University Medical Center, Jerusalem, Israel.

H Knobler (H)

The Institute of Diabetes, Endocrinology, and Metabolism, Kaplan Medical Center, Rehovot, Israel.

R Balicer (R)

Clalit Research Institute.

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